SRI BIJOY KUMAR DAS,PRESIDENT:-
Deficiency in service in respect of illegal repudiation of insurance claim of complainant insured cow are the allegations arrayed against the Opp.Party-Insurance Company.
2. Complaint, in brief reveals that, Complainant purchased a Black Bovin/CBZ cow under income generating programme sponsored by Govt. of Odisha. The cost of the cow was Rs.15,000/- and said cow was insured with United India Insurance Co.Ltd. and complainant paid Rs.87/- as his share of premium towards the insurance of the cow. It is stated that after acceptance of the proposal insurance company allotted a ear tag bearing No.310003534183. On dtd.07.11.2016 the insured cow died due to Tryparosumiasic disease and postmortem was conducted by the concerned Veterinary Surgeon. Accordingly, complainant lodged a written claim before OP No.1 and to forward the claim application to OP-Insurance Company for its settlement. But OP-Insurance Company vide their letter dated 04.07.2017 repudiated the claim on ground that at the material time of death of the cow, the policy was not in force and the claim was decided as ‘No claim’. +Complaint petition reveals that, the insurance policy was valid at the time of death of the cow and the insurance papers are available with OP-Veterinary office. The illegal repudiation of insurance claim caused financial loss and mental agony to the complainant. Hence, it is prayed that a direction may be given to OP-Insurance Company to settle the claim of the deceased cow to sum assured of Rs.15,000/- and to pay Rs.25,000/- as compensation alongwith cost of litigation.
3. OP No.1,Addl.Veterinary Asst.Surgeon on receipt of the notice appeared and filed written statement with supporting documents into the dispute. The written statement of OP No.1 reveals that complainant purchased a CBZ cow which was insured on dtd.16.11.2015 for a period of one year. The proposal-cum-schedule form for OLRDS-CP live stock insurance scheme alongwith premium amount was deposited with C.D.V.O.,Kendrapara on dtd.16.11.2015 and Ear tag number of cow was 310003534183. It is averred that the cow was suffering from illness and died on dtd.07.11.2016, and all the documents related to death of the cow was submitted before C.D.V.O. vide letter No.396 dtd.20.01.2017. It is also averred that, the letter of the insurance company dtd.04.07.2017 in connection to claim of the complainant declared as ‘No claim’ on ground that at the time of death of the cow, the insurance policy was not in force. OP No.1 countering the grounds of repudiation of claim issued a letter to OP-Insurance Company on dtd.19.07.2017 for consideration and settlement of claim.
OP No.2, Chief District Veterinary Officer,Kendrapara appeared into the dispute, only filed documents in connection to deposit of premium, Postmortem report and etc..
OP No.3 Senior Branch Manager,United Insurance Company though filed written statement after lapse of statutory of period of filing of written statement as provided in the C.P.Act,1986, accordingly set ex-parte U/S-13(2)(b)(ii) of the C.P.Act,1986 vide order No.7 dtd.10.05.2018.
OP No.4, Chief Executive Officer,Odisha Live Stock Resource Development Society(OLRDS) filed their written statement averred that as per the agreement between DAH & VS and United India Insurance Co.Ltd. dtd.07.02.2015 the policy will take effect immediately upon identification of the animal after due examination by VAS, assessment of value and its tagging alongwith payment of farmer’s share of premium to the Insurance Company. In the present case, the proposal-cum-schedule was signed on dtd.16.11.2015 and farmers share of premium for 14 persons including the name of the complainant were collected and submitted to the OP-Insurance Company through the CDVO,Kendrapara on dtd.10.12.2015. It is also averred that as per the agreement, the insurance policy in the dispute covers from the period dtd.16.11.2015 to dtd.15.11.2016, but OP-Insurance Company wrongly covers the period from dtd.07.07.2015 to dtd.06.-07.2016, as the cow is identified by AvAS on dtd.16.11.2015, the date of fixing the ear tag. It is further averred that the CDVO,Kendrapara vide their office letter No.2492 dtd.30.08.2017 requested the Branch Manager,United India Insurance Co.Ltd. to consider the case of the complainant, but said letter was not responded by the OP-Insurance Company.
4. Heard the authorized representative of complainant and case of the OP No.1,2 and 4 on merit and ex-parte hearing against OP No.3.-United India Insurance Company Ltd., perused the documents filed by the parties. The facts of the case are that complainant purchased a CBZ cow amounting of Rs.15,000/- under a State Govt. sponsored scheme. The cow was insured with OP-United India Insurance Company and the ear tag no.of the said cow is 310003534183,it is also admitted fact that the process of insurance of livestock/cow is rooted through the concerned veterinary offices and proposal/premium of the beneficiaries in a group are deposited before the insurance company for obtaining the policy of the livestock. It is also a fact that the said cow of the complainant died on dtd.07.11.2016 and claim amount of the deceased cow towards settlement of insurance was repudiated by OP-Insurance Company vide letter dtd.04.07.2017 on the ground that on the date of death of the cow dtd.07.11.2016 did not covers the policy as the policy period of the cow covered from dtd.07.07.2015 to dtd.06.07.2016.
In the case in hand the only issue to be decided here that, whether the insurance policy of the cow was in force on the date of death of the cow valid or not ? and the repudiation letter issued by OP-Insurance Company whether is legally sustainable or not ? The reason of repudiation of claim by OP-Insurance Company is discussed earlier. On the otherhand the other Ops,(OP NO.1,2 and 4) countering the version of the OP-Insurance Company state that the insurance policy of the deceased cow covered the period from dtd.16.11.2015, to dtd.15.11.2016. OP-Veterinary offices to support their case filed attested photo copy of proposal-cum-schedule Form which reveals that the total amount of premium towards policy of the cows of 14 beneficiaries including the complainant has been signed on dtd.16.11.2015 and the letter No.2492 dtd.30.08.2017 of OP No.2,CDVO,Kendrapara reflects that the premium amount of complainant deposited on dtd.04.12.2015 and in the said letter OP No.2 counters the ground of repudiation of claim and requested the OP-Insurance Company to re-consider the claim. Further, no such reponse to the letter of OP No.2 dtd.30.08.17 from the side of OP-Insurance company does not see the light of the day. It is also clear that, the cow-card issued by Addl.Veterinary Asst.Surgeon,Garadpur in the name of the complainant on dtd.16.11.2015. On perusal of clause-7 of the agreement executed between OP-Insurance Company and Director Animal Husbandry and Veterinary Service, it is clear that the policy cover will take effect immediately upon identification of animal, its examination by veterinarian, assessment of its value and its tagging alongwith payment of share of premium to the insurance company or its representation by the owner are completed. In the present dispute the deceased cow was identified by the veterinary doctor on dtd.16.11.2015 and allotted the ear tag no. and subsequent insurance process started on or after dtd.16.11.2015. It is abundantly clear that the insurance policy of the deceased cow was started from dtd.16.11.2015 and valid up to one year, not from dtd.07.07.15 to dtd.06.07.2016 as stated by OP-Insurance Company in their letter dtd.04.07.17 addressed to CDVO,Kendrapara. Hence, in the circumstances the repudiation of claim of the complainant by OP-Insurance Company is illegal and arbitrary and violates the terms and conditions of agreement executed on dtd.07.02.2015 and complainant is entitled to avail the sum assured against his claim as his insured cow died on dtd.07.11.2016(as revealed from the Postmortem report and other ancillary documents) during the insurance cover period of the deceased cost. We, feel surprise that how an insurance company without applying their mind and not considering the terms and conditions of the agreement and letter of OP No.2 dtd.30.08.2017 whimsically rejected the claim by creating an imaginary date of coverage period of the deceased cow and put the complainant like a common man to suffer financial loss and mental agony and dragged the complainant into a unnecessary litigation. Here, we rely on a decision of Hon’ble Apex Court “Gurgaon Gramin Bank-Vrs-Khazani and another,IV(2012)CPJ S(SC). No relief is sought against OP No.1,2& 4, accordingly the said Ops are freed from allegation of deficiency in service and OP-Insurance Company is held liable for deficiency in service.
Having observation reflected above, it is directed that OP-Insurance Company shall release an amount of Rs.15,000/-(Rupees Fifteen thousand) only as insurance claim amount towards death of complainant’s cow. It is further directed that OP-Insurance Company shall pay prevailing simple rate of interest on the sum assured starting from dtd.07.11.2016 to till its realization. It is further directed that OP-Insurance Company shall pay an amount of Rs.1,000/-(Rupees One thousand)only towards cost of litigation to the complainant and the total ordered amount shall release within one month from the date of receipt of this order, failing to comply the order penal provisions be initiated against the OP-Insurance Company as per the provisions of C.P.Act,1986.
The complaint is allowed in part with cost on ex-parte against OP No.3.
Pronounced in the open Court, this the 21st day of January,2019.
I, agree.
Sd/- Sd/-
MEMBER PRESIDENT
